Project Summary The Lancet recently published a 3-part series calling attention to the global epidemic of LBP and the need for innovative new solutions. LBP is a leading cause of physical disability (experienced by 60-85% of adults) and missed work (>100 million days per year in the U.S. alone), and results in costs >$100B per year in the U.S. alone. The physical demands (e.g., leaning and lifting) of nursing and other professions (e.g. logistics and manufacturing) are at particularly high risk of developing LBP. This often leads to physical disability, healthcare costs and missed work. There are currently no solutions for this job that are effective, affordable, and practical. This project is focused on a game-changing new technology: a spring-powered exosuit - called mechanized clothing (MC) - that blends the assistive benefits of exoskeletons with the form-factor and comfort of daily clothing to reduce LBP and injury risks. MC provides a low-profile way to offload low back muscles during leaning or lifting tasks. MC is poised to be the first and only wearable device that can effectively reduce stress on the lower back, and safely and affordably integrate into the workflow of nurses and other occupations that involve repetitive lifting and leaning. Long-term, MC is expected to: (a) fit under daily clothing and into everyday life, (b) augment biomechanics to reduce low back loading, and (c) reduce incidence of LBP and injury and (d) reduce associated costs. The investigators interviewed over 100 end users, revealing that current assistive devices are unable to effectively integrate into daily working environments. The objective of this SBIR project is to demonstrate commercial and technical feasibility of MC by addressing a key challenge that no other exoskeleton has overcome: integration, i.e., demonstrating that workers can be assisted without interfering with their daily workflow. To accomplish this, the investigators propose the following aims: 1) redesign the actuation system to be lower profile while maintaining battery life, enabling in-field testing and ensuring there are no protruding components that could get caught on the work environment; 2) perform reliability and fatigue tests on the MC clutch, and then refine clutch design as needed to ensure reliability and robustness for real-world testing; and 3) demonstrate feasibility of device integration into a real-world environment by testing nurses and material handlers wearing the MC prototype and assessing the degree to which it can assist without hindering their workflow (e.g., without degrading range of motion or interfering with sitting down). If MC surpasses Phase I success metrics related to workplace integration, the investigators plan to submit a Phase II proposal to further develop MC toward a commercially viable product. 1